20170143 ROW Permit Pkg 03212017City of Yelm
PUBLIC WORKS
901 Rhoton Rd NW
Yelm, WA 98597
Phone: 360 - 458 -8406
FAX: 360 - 458 -8417
Permit No.
,r 4 3
Application to Perform Work on
Public Right of Way and /or Connect
to Utilities
APPLICATION
The undersigned hereby makes application to:
Bore from base of pole in front of building to rear of sidewalk, then 115' along sidewalk,
placing 1 -2" conduit @ 36" depth before turning to private property.
Location of work:
16628 Highway 507 (Christensen's Home Furnishings - Comcast job # 238089)
I agree to perform the work in strict compliance with Yelm Municipal Code, the special conditions enumerated
herein and the attached conditions I have read and will adhere to the general provisions applicable to permits
contained on this form.
The Public Works Department (360- 458 -8406) must be contacted for inspection 24 hours before work
commences or this permit will be void.
The Underground Utilities Coordinating Council (1- 800 - 424 -5555) must be contacted two (2) working days
before proceeding with any excavation associated with this permit.
Name: Steve Harshfield
Address:4610 Tacoma Ave, Sumner, WA 98390 Phone: 253 - 266 -4741
Proposed starting date of installation: 4/1 /17 Dura ' n: 3o de
Date: 3/15/17
Signature:
PERMIT REQ1PEMENTS '
For Official Use Only
Fee $ Ih 0V
Issued ,l
Fee Received $
Application Approval
Signature: l°
Receipt Number 2.
To Be Completed By City
Permission is hereby granted to perform the above described work subject to the general provisions contained
on this form, ano the following special conditions:
m ' J
A
d
A bo d in the amount of is required to insure compliance with the above
conditions, refundable upon satisfactory completion of work.
No work shall be done under this permit until the party or partiestp whom it is granted shall have
communicated with and received instructions from: u�
Remarks:
First Inspection
Date:
Inspector Final Project
Completion Approval:
Date:
Revised 03/09/2011
p MOTOOFMI
MAR ' " Nei
BY-- -------------- - - - - --
City of Yelm
Community Development Department
Building Division
Phone: (360) 458 -8407
Fax: (360) 458-3144
Applicant:
Name: SEFNCO COMMUNICATIONS, INC.
Address: 4610 TACOMA AVE
SUMNER WA 98390
Property Information:
Site Address: 1 RR7R HWY -r%n7 SF
Assessor Parcel No.: 64303400501
Contractor Information:
Name: SEFNCO COMMUNICATIONS, INC
Address:
4610 TACOMA AVE
SUMNER WA 98390
Contractor License No.:
Permit No.: 20170143
Issue Date: 3/2112017
(Work must be completed within 180 days)
Phone: 360- 829 -0460
Owner:
Subdivision:
Phone:
Expires: 0 /00 /0000
Lot:
Project Information:
Project: UTILITY
Description of Work: BORE FROM BASE OF POLE IN FRONT OF BUILDING TO REAR OF SIDEWALK, THEN 115
FT ALONG SIDEWALK, PLACING 1 TO 2 INCH CONDUIT AT 36 INCH DEPTH BEFORE
TURNING TO PRIVATE PROPERTY
Sq. Ft. per floor: First Heat Type (Electric, Gas, Other):
Second
Third
Garage
Basement
Fees:
Item
RIGHT OF WAY
Contractor
SEFNCO COMMUNICATIONS, INC.
TOTAL FEES:
Applicant's Affidavit:
I certify tha I have read and examined the information contained within the application and know the same
to be true d correct. I also certify that the proposed structure is in conformity with all applicable City of
Yelm regI a ionsITcluding tho a governing zoning and land subdivision, and in addition, all covenants,
easemen nd %�strictions of ecord. If applying as a contractor, I further certify that I am currently
registere thef $tate of W shinqton. A
Fees
$ 125.00
$ 125.00
OFFICIAL USE ONLY
# Sets of Prints:
Final Inspection:
Date:
By:
Cite of Yelm
{36 i) 458 -3244
RECD': 00263676 3/21/2017 C�:38 PM
OPEP: CO TERM: 001
REFA': 59047
PAID BY:
TRAM: 33.0000 BUILDING PERMITS
20170143 125.0(CR
SEFNCO COMMUNICATIOPS, INC.
16628 HWY 507 SE
ROW 125.0(CR
ll :NDERED: 125.00 (HECK
APPLIED: 125.00 -
CHANGE: 0.00
Ln
LL
0
u
0
a
o:
W
0
CT
H
W
LLJ
0
Z
cc
co
CN
0
%10
0
7
M
c
<
CL
LU
0 >:
0
106th
Ave SE
C
CL
E
0
w
w
"D ot:
LU
0
L-
0
C)
Ln
@j 0-
0
t: w
z
M
2:1
CL
CL
C L
ui <
CL U
0
L" V) D-
LU
FE
0
iii
Z)
W
Q
0
o
u
LLI
X15
>
CU
L) (D
LU z
P:
LU r,4
z 1� 0
LL
0
_C-
0
0
ow: Ln
0. x
LU
L) LU
- u Z
< =
LLI
2
co
CD
LU
0
F-
__j
a- a-
0
co
0 Lu
rN
tA
1
(LI
L-
.5
CL
O
I i
LU
z
ui
Cr
0
co
kA
z
>
0
a{ 0
ui
Ln
r-
�-%
Ln
>
4,
U
M
Jz
C)
E
00
cr
LLJ
tw
c
e
Lu
m
V>
C,
0
CL
Z
J
ro
AM
Q
CL
D
00
LL
-a
Q)
m
Qj
Qi
m
u
Qj
E
to
0
y
4.
Ln
cB
Cu
0
N
C)
Lr)
< 00
0)
u
O
a
W
<
CC- Ln
@)
>�
00
en
C*4
M
&A
cu
z
LU 0
U)
<
U
--L 0
LLJ U-)
>- 2 -a
0
Q
0
z
Zoo
0 0
J °-0
�t
o
0
F-
>
a
M:
u
c:T 0
<
u
LU
0
Z
Ln
z
u
0
i
u
0
Ln
0
u
z
<
CA
E
IM
Ll-
LU
<
E
0
LU
n
0
2
0
w
u
Lu m
L)
6
u
:� =
Q-
0
i=
z
r-
C)
CY)
Lr)
0
LU
> ry)
< 00
CY)
LU
LLJ
ui
0
U.j
U')
00
CY)
V)
LLJ
U-
< < H
Z LU
U-i
W
<
0
u
>
0
LL
L4r)
z
LLJ
<
a_
0
u <
CD
u
_0
(1)
(A
u
LL-
0
uj
00
00
U
<
0 -r
U LLJ
< Lu
Z
LU
0
>
>
LD
LL
<
0
4-0
C)
00
2i
-1
Z
z >
LL LLJ
r,4
o 2i .
T--i rn
F- 0
U
LU
0 0
LU
I=
�-
m
u
LU
ro
N
U
0
U
Lu
Ln Ln
tD D Ln
U) r,4
V)
LU I
r-q
I I
r'l m
I
't
I
Ln
w
71
>
W
VYI]3d
9
�11 z
z
=z
Li
m
(A
E
0
0
Z)
W13A
0
E
z
0
-k
(A
MCODU
(99
ai
Ln
=
a
00
w
`
a
L,
w "') w
a @°
N w -
CL U cn 0 w
J
O 2 z
H O M O
W
W z L N
Z
O N w w 0
U Z
O a a
H
j
0
z z
_ o w
A
w r-I _
~
i
L
f
0
W
;
3
L A l
2
0
L ,
N
LL
O
�O
m
W
cc
W
N
LLI
z
W r-I
z
W
a
a
O
o
J
W
LL
W
f-
cc
L
N
=
W
W
M
V
0
m
0
o
LL.
Z
D1
W 0
°
z V
a
2
a
zI^
V
Z
W
00
O
00
M
_'^
C/) V!
z
CD
N
CD H .o
Q U
ME Z
LU
CO3 °
U
ff
W
.
W
i
J
az
N
W
-
.,
3